Hank Hayes

JOHNSON CITY — Tennessee Gov. Phil Bredesen made a serious sales pitch for expanding his pre-kindergarten program and enacting a long-term care initiative to an April Fools’ Day audience of Johnson City Rotarians Tuesday.

On a day known for pranks, Bredesen joked that he was glad a large crowd of club members and guests showed up for his luncheon talk at the Johnson City Country Club.

“I was also concerned that I would fly up here and arrive at the country club ... and nobody would be here,” he said.

After the lighthearted start to his talk, Bredesen detailed his $25 million proposal to fund up to 250 to 300 new pre-K classrooms in a tight budget year.

“Education continues to be my number one priority. ... Whatever financial situation we find ourselves in, that is not going to change,” said Bredesen, a Democrat. “Someone said to me at the last event I was at that I might be remembered as the education governor. My retort was ‘That would be nice, but I would love to be known as the children’s governor.’”

He said Tennessee, with more than 800 pre-K classrooms established in four years, is being viewed as a national model for early childhood education.

“I don’t want us to fall off course here. We need to continue making this a priority,” Bredesen told the club.

Another priority, Bredesen said, is using existing Medicaid funds in the TennCare program for his long-term care initiative to serve more people in cost-effective home and community settings. TennCare is the state’s largest single payer of long-term care services.

Bredesen said that, if approved by lawmakers, managed care organizations would handle the initiative. He acknowledged there would be economic tension between insurers and providers as in most health care offerings.

AARP supports the initiative, while the Tennessee Republican Party (TRP) wants more credit for the move for one Republican state senator.

In Tennessee, care in a nursing home costs about $66,000 a year, while two hours of daily care in the home costs about $14,000 a year, according to surveys by Metlife Mature Market Institute.

Despite that, nearly 99 percent of almost $1 billion in federal funding for long-term care services goes to nursing homes in Tennessee, with only $10.8 million spent on home and community-based services such as caregiver respite and delivered meals, according to data from the Centers for Medicare and Medicaid Services.

Bredesen said with this much money at stake, there’s a “protectionist mentality out there” — particularly in Tennessee’s nursing home industry.

“Health care is hard enough to manage when you’re young and healthy,” he said. “When you’re older and sick you shouldn’t be forced to navigate this complex system.”